Evolving treatment patterns and outcomes in older patients (>= 60 years) with AML: changing everything to change nothing?
Por:
Martínez-Cuadrón D, Serrano J, Gil C, Tormo M, Martínez-Sánchez P, Pérez-Simón JA, García-Boyero R, Rodríguez-Medina C, López-Pavía M, Benavente C, Bergua J, Lavilla-Rubira E, Amigo ML, Herrera P, Alonso-Domínguez JM, Bernal T, Colorado M, Sayas MJ, Algarra L, Vidriales MB, Rodríguez-Macías G, Vives S, Pérez-Encinas MM, López A, Noriega V, García-Fortes M, Ramos F, Rodríguez-Gutiérrez JI, Costilla-Barriga L, Labrador J, Boluda B, Rodríguez-Veiga R, Martínez-López J, Sanz MA and Montesinos P
Publicada:
1 jun 2021
Ahead of Print:
1 oct 2020
Resumen:
There are no studies analyzing how therapeutic changes impact on outcomes of older AML patients. This study analyzes patient ' s and disease characteristics, treatment patterns, and outcomes of 3637 AML patients aged >= 60 years reported to the PETHEMA registry. Study periods were 1999-2006 (before hypomethylating agents-HMAs availability) vs 2007-2013, and treatments were intensive chemotherapy (IC), non-intensive, clinical trial (CT), and supportive care only (SC). Median age was 72 (range, 60-99), 57% male, median ECOG 1 (range, 0-4), secondary AML 914 (30%), with adverse-risk genetic in 720 (32%). Treatment differed between study periods (1999-2006 vs 2007-2013): IC 58% vs 32%, non-intensive 1 vs 23%, CT 0 vs 2%, SC 27 vs 28% (p < 0.001). Median OS was 4.7 months (1-year OS 29% and 5-years 7%, without differences between periods), 1.2 for SC, 7.8 for non-intensive, 8.6 for IC, and 10.4 for CT (p < 0.001). OS improved in the 2007-2013 period for IC patients (10.3 vs 7.5 months,p = 0.004), but worsened for SC patients (1.2 vs 1.6 months,p = 0.03). Our real-life study shows that, despite evolving treatment for elderly patients during the last decade, OS has remained unchanged. Epidemiologic registries will critically assess whether novel therapies lead to noteworthy advances in the near future (#NCT02606825).
Filiaciones:
Martínez-Cuadrón D:
Hospital Universitari I Politècnic La Fe, Valencia, Spain
CIBERONC, Instituto Carlos III, Madrid, Spain
Serrano J:
Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain
Gil C:
Hospital General Universitario de Alicante, Alicante, Spain
Tormo M:
Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, Valencia, Spain
Martínez-Sánchez P:
Hospital Universitario 12 de Octubre, Complutense University, i + 12, CNIO, Madrid, Spain
Pérez-Simón JA:
Hospital Universitario Virgen del Rocío, Sevilla, Spain
:
Hospital General Universitari de Castelló, Castellón, Spain
Rodríguez-Medina C:
Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas, Spain
López-Pavía M:
Hospital General Universitario de Valencia, Valencia, Spain
Benavente C:
Hospital Clínico San Carlos, Madrid, Spain
Bergua J:
Hospital San Pedro Alcántara, Cáceres, Spain
Lavilla-Rubira E:
Hospital Lucus Augusti, Lugo, Spain
Amigo ML:
Hospital General Universitario Morales Meseguer, Murcia, Spain
Herrera P:
Hospital Univeristario Ramón y Cajal, Madrid, Spain
Alonso-Domínguez JM:
Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
Bernal T:
Hospital Universitario Central de Asturias, Asturias, Spain
Colorado M:
Hospital Universitario Marqués de Valdecilla, Santander, Spain
:
Hospital Universitario Doctor Peset, Valencia, Spain
Algarra L:
Hospital General Universitario de Albacete, Albacete, Spain
Vidriales MB:
Hospital Clínico Universitario de Salamanca, Salamanca, Spain
Rodríguez-Macías G:
Hospital General Universitario Gregorio Marañón, Madrid, Spain
Vives S:
ICO-Hospital Germans Trias i Pujol, José Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
Pérez-Encinas MM:
Hospital Clínico Universitario de Santiago-CHUS, Santiago de Compostela, Spain
:
Hospital Arnau de Vilanova, Valencia, Spain
Noriega V:
Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
García-Fortes M:
Hospital Universitario Virgen de la Victoria, Málaga, Spain
Ramos F:
Hospital Universitario de León, León, Spain
Rodríguez-Gutiérrez JI:
Hospital Universitario de Basurto, Bizkaia, Spain
Costilla-Barriga L:
Hospital Universitario Miguel Servet, Zaragoza, Spain
Labrador J:
Hospital Universitario de Burgos, Burgos, Spain
Boluda B:
Hospital Universitari I Politècnic La Fe, Valencia, Spain
Rodríguez-Veiga R:
Hospital Universitari I Politècnic La Fe, Valencia, Spain
Martínez-López J:
CIBERONC, Instituto Carlos III, Madrid, Spain
Hospital Universitario 12 de Octubre, Complutense University, i + 12, CNIO, Madrid, Spain
Sanz MA:
Hospital Universitari I Politècnic La Fe, Valencia, Spain
CIBERONC, Instituto Carlos III, Madrid, Spain
Montesinos P:
Hospital Universitari i Politècnic La Fe, Valencia, Spain.
CIBERONC, Instituto Carlos III, Madrid, Spain.
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